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I hereby certify that no one in my household has come in close contact with anyone that has tested positive for COVID-19 or exhibited any of the symptoms listed below .
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the
World Health Organization. COVID-19 is extremely contagious and is believed to spread
mainly from person-to-person contact. As a result, federal, state, and local governments
and federal and state health agencies recommend social distancing and have, in many
locations, prohibited the congregation of groups of people.
La Dee Da, LLC has put in place several preventative measures to reduce the spread of
COVID-19; however, La Dee Da cannot guarantee that you or your child(ren) will not
become infected with COVID-19. Further, attending La Dee Da’s summer camp program
could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and
voluntarily assume the risk that my child(ren) and I may be exposed to or infected by
COVID-19 by attending La Dee Da’s Summer Camp program and that such exposure or
infection may result in personal injury, illness, permanent disability, and death. I
understand that the risk of becoming exposed to or infected by COVID-19 at La Dee Da
may result from the actions, omissions, or negligence of myself and others, including,
but not limited to, employees, camp counselors, and program participants and their
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for
any injury to my child(ren) or myself (including, but not limited to, personal injury,
disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I
or my child(ren) may experience or incur in connection with my child(ren)’s attendance at
La Dee Da or participation in La Dee Da’s programming (“Claims”). On my behalf, and
on behalf of my children, I hereby release, covenant not to sue, discharge, and hold
harmless La Dee Da, LLC, its employees, agents, and representatives, of and from the
Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind
arising out of or relating thereto. I understand and agree that this release includes any
Claims based on the actions, omissions, or negligence of La Dee Da, LLC, its
employees, agents, and representatives, whether a COVID-19 infection occurs before,
during, or after participation in any Summer Camp Program.